Schizophrenia News: June 2013

  • A novel treatment for hearing voices showed promising results in an early trial.

    The voices can be controlled and sometimes silenced by confronting a computer avatar of the voices.

     

    A pilot study of 16 patients in the British experimental treatment ("avatar therapy") indicated almost all of them reported a reduction in the frequency of the voices and the severity of distress the voices caused the participants.

     

    The first thing to do in the therapy is that the patient creates a computer-based avatar by choosing a face and a voice for the entity they perceive is talking to them.

     

    The therapist speaks to the patient through the computer-generated avatar in real time.  The patient is encouraged to oppose the voice and slowly the therapist teaches them to take control of their hallucinations.

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    The individuals in the study often told Julian Leff, the developer of avatar therapy, that the voices were the worst feature of their illness.

     

    Three of the study participants stopped hearing voices completely after working with the avatar system.

     

    The avatar therapy sessions were recorded on an MP3 player and each patient took one home so he could listen to it at any time when the voices threatened to take control.

     

    The medical charity The Wellcome Trust has given Leff's team 1.3 million pounds ($2 million) to test the therapy in a larger group of individuals.

     

    If the larger trial is successful, avatar therapy might be widely available within a few years.  The technology is relatively simple and most mental health professionals have the skills to deliver it.

     

    (Avatars help schizophrenia patients silence tormenting voices, retrieved on May 29, 2013 from http://www.reuters.com/article/2013/05/29/health-schizophrenia-avatar...)

     

    A study from Columbia University Medical Center (CUMC) indicates an excess of the brain neurotransmitter glutamate may cause a transition to psychosis in people at risk for schizophrenia.  The findings were published in Neuron.

     

    The researchers used neuroimaging tools in patients and a mouse model.  They followed 25 young people at risk for schizophrenia to determine what happens to the brain as they develop the disorder.  The following pattern was found in patients who progressed to schizophrenia: glutamate activity increased in the hippocampus then hippocampus metabolism increased.  Then the hippocampus began to atrophy.

     

    In theory, the dysregulation of glutamate and hypermetabolism could be identified by imaging individuals who are either at risk for or in the early stage of the disease.  It's thought treatment to control glutamate release might protect the hippocampus and prevent or slow the progression of psychosis.

     

    Bita Moghaddam, professor of neuroscience and of psychiatry at the University of Pittsburgh, suggests that if excess glutamate is a factor for high-risk individuals it might explain why a first psychotic episode is often caused by periods of stress.

     

    Stress increases glutamate levels in the brain.

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    (In the Brain High Levels of Glutamate May Kick-Start Schizophrenia, retrieved on May 23, 2013 from http://www.medicalnewstoday.com/releases/259372.php)

     

    Research indicates that individuals that experience negative symptoms of schizophrenia are less likely than mentally healthy people to increase their efforts for higher levels of reward.

     

    As well, the study participants with schizophrenia were less motivated to engage in higher levels of effort for the receipt of uncertain rewards.

     

    The results were published in Biological Psychiatry.  James Gould of the University of Maryland School of Medicine and colleagues suggest the motivational impairments of schizophrenia could be associated with abnormalities in estimating the cost of effortful behavior.

     

    44 patients with schizophrenia were evaluated in effort-cost decision making along with  36 age- and gender-matched controls. They performed a computerized task that examined the effects of reward value and probability on making high- and low-effort decisions.

     

    The payoff was 100 percent certain in half the trials and in the other half of the trials the payoff was uncertain (50 percent).

     

    Individuals with schizophrenia in the 100 percent probability trials were less likely than the controls to select the high-effort response alternative.  They were also less likely to select the high-effort response when the payoff was highest.

     

    Gold and colleagues report these impairments in effort-cost computations were greatest among patients with schizophrenia with elevated negative symptoms.

     

    The researchers suggest that medication dose has no effect on the patients' decision making, because the altered effort-cost computations in schizophrenia are not a consequence of antipsychotic treatment-induced dopaminergic blockade.

     

    (Schizophrenia dampens volition, retrieved on February 18, 2013 from http://www.news-medical.net/new/20130214/schizophrenia-dampens...)

Published On: June 13, 2013